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AMENDMENT #1 <br />Payment <br />Task Task! ActivitylDescription *May Support PHAB Deliverables/Outcomes Due Date/Time Information <br />Number StandardslMeasures Frame and/or <br />Amount <br />Women, Infants , and Children (WIC) program or a involvement, and the case <br />Registered Dietitian Nutritionist (RDN) for a information provided to them <br />nutritional assessment and to other service providers as <br />appropriate <br />d) Coordinate services and communicate regularly with <br />members of the case management team <br />*For Information Only: <br />Funding is not tied to the revised Standards/Measures listed here. This information may be helpful in discussions of how program activities might contribute to meeting a <br />Standard/Measure. More detail on these and/or other Public Health Accreditation Board (PHAB) Standards/Measures that may apply can be found at: <br />h!tp:J/\Vww.ph aboaraorg!wp-conrentiuploadsfPHAB-Standaros-and-Measures-Version-l .O.pdf <br />Program Specific Regu..irements/N arrative <br />Program Manual, Handbook, Policy References <br />A Targeted Approach to Blood Lead Screening in Children, Washington State <br />2015 Expert Panel Recommendations <br />httpS j/www .doh.wa.gov/PortaIsJllDocwnerus/Pubsl334-383 .pdf <br />Special References (RCWs, WACs, etc) <br />Laboratories are required to report to the Dep artment of Health all Blood Lead test results (WAC 246-10 I -20 1). Elevated results (~5 mcg/dL) must be reported within 2 days; non- <br />elevated results ::;5 mcg/dL need to be reported within one month . <br />Monitoring Visits (frequency, type) <br />Telephone calls with contract manager at least once every quarter. <br />Definitions <br />BLL-Blood Lead Level <br />EBLL-Elevated Blood Lead Level <br />PEHSU-Pediatric Environmental Health Specialty Units <br />Special Billing Requirements <br />Payment is contingent upon DOH receipt and approval of all deliverables and an acceptable written report to include a plan of care . Payment to completely expend the "Total <br />Consideration" for a specific funding period will not be processed unt il all deliverables are accepted and approved by DOH. Invoices must be submitted monthly by the 30th of <br />each month following the month in which the expenditures were incurred and must be based on actual allowable program costs. Billing for services on a monthly fraction of the <br />"Total Consideration" will not be accepted or approved. <br />Exhibit A, Statements of Work <br />Revised as of January 16 ,2018 <br />Page 5 of6 Contract Number CLH18249-1